Category Archives: relationship

The Best Thing That Could Happen

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What do you think is the best thing that could happen out of the COVID-19 pandemic?

I think it’s Connection.

How ironic, as the current best solution to mitigating illness and death is physical (not really social) separation.

Connection won’t come easily, though.  Today I felt all kinds of yuck:  Conflicted.  Unsettled.  Angry, Cynical, Fearful, Guilty, Annoyed, Confined, Enraged.  Not exactly connecting emotions.  The people going about their usual routines, disregarding distancing guidelines, and claiming it as their right to ‘live free’ agitate me the most.  When they get sick, and after they have infected numerous others, some gravely, my colleagues and I will care for them the same as for those who followed the guidelines and acted unselfishly for the greater good.  We will put ourselves in harm’s way, and more of us will pay with our lives for their false freedom.  Because when your ‘right’ to ‘live free’ puts others’ lives at risk, that is not freedom.  That is negligence.

That said, I’ve not lost all hope.  Through Facebook, Zoom, email and snail mail, I am now better connected with some folks than before, and I’m grateful.  They have helped me consider and envision the best possible New Normal on the other side of COVID-19.  I share my wish list below, as well as links to my favorite articles from the past week.

Also, join me this Wednesday, April 8, at 6pm Chicago time for an Instagram live chat.  Owners Tim and Victoria at Ethos Training Systems will host a fireside-style session on COVID-19.  You can join by finding me, chenger91, or Ethos, at the time above.  Please know that I do this public event as a friend of Ethos, and not as a representative of my employer or any medical professional society.  I claim no expertise in infectious disease or epidemiology; I’m just one doctor doing my best to share relevant information and practical advice.

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To Create Our Best Post-COVID Future, Let Us:

Continue to connect earnestly with people near and far.

Advance toward universal healthcare in some form, and shore up our social safety nets.

Reclaim our collective mindset—temper extreme individualism with more altruism and empathy.

Slow down—maintain more flexible work schedules, better childcare options.  Generate less pollution, decrease unnecessary production and consumption.

Live more mindfully and in the present:  Enjoy the good more and dwell less on the bad.  Increase both awareness and appreciation of all that is well in life.

Hold rigorous science and medicine far above opinion and ideology.

Practice Learning, Flexibility, Agility, and Resilience, in all domains, large and small, individually and as a collective.

Recognize our shared humanity, maintain that recognition, and act consistently from that recognition—bake it into our cultural norms henceforth.

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Pieces that helped me the past week:

An excellent review of the evolution of and rationale for universal masking:  https://www.vox.com/2020/3/31/21198132/coronavirus-covid-face-masks-n95-respirator-ppe-shortage?fbclid=IwAR237JXMUy94AcI_4uigdP3ZZUfoNd1c_4tyRDi-A8u2BYm7YZmSJ0f3ii8

A summary of current knowledge of SARS-CoV-2 and COVID-19, written accessibly and with practical recommendations, by my teacher and colleague, Dr. Alex Lickerman:  https://imaginemd.net/blog/coronavirus-april-2020-part-5/?fbclid=IwAR20m7QfOSUlZlAZuTaytKDaw210j_wWuqd6xgGBeTbIHAEfZeASfDnYTac

Dr. Lickerman doing a similar review as a guest on a podcast, also excellent: https://www.larryweeks.com/ep-36-coronavirus-qa-with-dr-alex-lickerman-m-d/?fbclid=IwAR077iOtNkCGcyjJdjVWZWKW6RWgtNhVgdN7cYvrnd2bQcbaStrRvTjdqAE

From Maria Shriver’s Sunday Paper:  But today is Palm Sunday, and Easter Sunday is a week away. This week is the beginning of Holy Week, a time of spiritual renewal and rebirth. So, I’m taking that as a sign that we aren’t meant to go back to what was. We are meant to go forward both individually and collectively. Each of us will come out of this time a different person, a changed human being. How could we not?
What a double tragedy it would be if we went back to the way we were. To a time when we didn’t care for our planet. To a time when we were so mean to one another. To a time when we were so divided in every way. To a time when we didn’t know our neighbors. To a time when so many only cared about themselves and saw others as the “other.”

A diagram shared on social media of our human responses to the crisis (I don’t know who created it—if you do, please give credit in the comments and tell them thank you).  I think it’s normal that we should find ourselves doing things in each of the nested circles every day.  We can exercise compassion for ourselves and others at the same time:

covid nested circles

Finally, a poem, also from Maria Shriver’s Sunday Paper, shared by her niece, who died with her 8 year-old son the very same day:

covid after poem maria shriver niece maeve

Things will likely feel worse for at least a few weeks before they feel better, my friends.  Hold tight to those you love and who love you.  Count your blessings.  Take perspective.  Consider deeply our inextricable and undeniable interconnectedness.  Be kind.

Sexism and Apologies 2020

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“If you say, ‘Yeah, there was sexism in this race,’ everyone says, ‘Whiner!’ If you say, ‘No, there was no sexism,’ about a bazillion women think, ‘What planet do you live on?’”

That is how Senator Elizabeth Warren answered a reporter when asked whether she thought gender played a role in her suspending her presidential campaign.  I recommend watching the whole video clip.  In case anyone wonders: if the question even needs to be asked, then yes, gender played a role.  But Senator Warren rightly called out the question for what it is: a trap for any woman running for high elected office.  Her statement summarizes it succinctly; she knows what’s what, and she names it without apology.

I was more upset than I expected when Aunt Eliz Crusader ended her campaign.   Megan Garber expressed the story of my profound disappointment eloquently in her piece for The Atlantic:  “America Punished Elizabeth Warren for her Competence”.  Basically she elaborates the apparently inevitable social equation for women:

Competent  +  Vocal  +  Unapologetic   =   “Strident”  +  “Shrill” +  “Condescending”

The past two weeks I have had a series of encounters wherein I find myself voicing opinions and positions more firmly than I might have in the past.  I feel confident and grounded in my knowledge and expertise.  I am professional and respectful.  I apologized for writing a long email, even though the words were necessary and clear.  My strong woman mentor reminded me to save apologies for when I actually commit a transgression.

What I have learned (perhaps again) in this time, however, is that relationship discord, even just the possibility of it, is what distresses me the most.  How will I be perceived for voicing my concerns, for advocating for my peers and teams?  How will a negative perception undermine my effectiveness?  Will it cost me my seat at this table or others?

Does any man ask himself these questions?

Given that I was already knee deep in vulnerability and self-doubt around these encounters, the Atlantic piece poked my fears and prodded them to the surface.  It shook me.  It also made me angry that here we still are, in 2020, unable to accept, let alone embrace, competent, vocal, and unapologetic women in leadership.  And it’s not just men; countless women also disavow their sisters.

I vented my disappointment on Facebook (of course):

“So it is down to three Old White Men.  Very disappointing.”

A friend tried to make light of the situation, pointing out that Donald Trump is the youngest of the three.  This attempt at levity (from the Right) felt like a nemesis rubbing salt in my fresh wound.  Twice I rebuffed; twice he persisted.  Finally I (voiced):  “I feel ignored and dismissed when I express distress and you make light of it.  Perhaps my distress is not clear to you, because you only know me through social media [we were friendly acquaintances in high school]; you may not know how upset I am.  But after two replies by me rejecting your attempt at humor, to have you schooling me [that humor is a ‘primary’ way] of dealing with [politics] just makes me more angry.”

Turns out he had mistyped; he’d meant to write that humor is one of his primary ways of coping with the absurdity of politics.  He apologized to me.  It felt sincere.  I was consoled, and I thanked him.

Competent and vocal.  Confident and unapologetic.  Respectful and humble.

We need all of these qualities and more to be true leaders.  Women, arguably, must work harder than our male counterparts to prove that we possess all of them.  Then we get punished when the proof proves irrefutable.  How sadly ironic.  The truth is we need many more of our leaders, men and women alike, to own, exude, and model these virtues.  The last two are not weak, though they may feel profoundly vulnerable, which is not the same thing.

I feel urgent impatience at the state of sexism in America.  But I know how to soothe and manage myself; I can reclaim the patient urgency of fierce optimism at my core.

I will persist.

Aunt Eliz has shown me how.

Caring for One Another

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Last Saturday a patient cared about me.

He had severe abdominal pain that had kept him up all night and he needed advice.  By the time we agreed on a plan he had apologized, at least three times, for ‘bugging’ me on the weekend.

I explained that it’s okay to ask for help on weekends. I’m happy to help if I can, and the relationship is the most meaningful part of my work.  I also thanked him for not abusing that relationship—for not taking me for granted, for seeing me not as a transactional service provider, but as a person with a life outside of work.

When we feel seen and appreciated, life is easier to take and we function better.

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Recently I’m thinking about organizational values and mission statements.

For the most part I find them superficial and unhelpful, wordy and convoluted.

As I consider the team I have led the past two years, I feel proud that although we have not formally written mission or values statements, we are nonetheless clear on both.  We define them in succinct language, gauge how we manifest them through action, and reconcile behaviors, conflicts, and initiatives against them regularly.

Our values, collectively adopted one year ago:

  1. Fun, joy, creativity
  2. Collaboration and Connection
  3. Accountability
  4. Kindness and Compassion

Reviewing the list, I see that caring for one another serves as the foundation for this house.  This applies both to the team’s inner work, as well as anything facing outward toward patients.

It is of course our responsibility as professional caregivers to manage ourselves and show up our best for our patients.  I expect patients to treat our team with respect, but we should not necessarily feel entitled to their caring about us, per se.  It is our job to care for them; the relationship is inherently imbalanced in that way.  In order to do that well, we the team must also care for and support one another in service of our vocation.

So every once in a while, when a patient expresses genuine caring for me or a member of the team, in addition to appreciation for a job well done, it really brightens our day.  It keeps us going.  It makes all the unappreciative, and even abusive, encounters worth it.

Thus, we march on.  We remember why we do this work and we hold each other up.

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Please know how much your expressions of affirmation matter to your medical team.

We’re all here caring for each other in this life.  The more we can remember that and act on it, the better off we will all be, no?